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Which is a better option – graft or CAPD?

Answered by: Dr Sridhar Reddy Allam

Capital Nephrology Medical Group,Sacramento, California, USA.

Q. My 65 years old mother is undergoing haemodialysis for the last six months. But she had two AV fistulas done but both failed due vein problem. After two catheters (Jugular and femoral), the doctor has put a permanent catheter on her chest but after 4 dialysis, it isn’t working. The doctor told us two options - one is a graft and another is continuous ambulatory peritoneal dialysis (CAPD). Which one is better? Please suggest.

A.  Given that she clotted her access (both catheters and fistulas) numerous times, she will need work-up for increased clotting state. Also, it may be worthwhile to rule out any central venous stenosis. If veins are small, graft is a good alternative. However, again, the key is how long it is going to work and to find out the reason why dialysis access has failed so many times. CAPD is a great alternative to haemodialysis with similar outcomes. Please talk to your nephrologist about this option.

A.  Given that she clotted her access (both catheters and fistulas) numerous times, she will need work-up for increased clotting state. Also, it may be worthwhile to rule out any central venous stenosis. If veins are small, graft is a good alternative. However, again, the key is how long it is going to work and to find out the reason why dialysis access has failed so many times. CAPD is a great alternative to haemodialysis with similar outcomes. Please talk to your nephrologist about this option.

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